Provider Demographics
NPI:1750435228
Name:HILL, ANGIE L (DDS)
Entity type:Individual
Prefix:DR
First Name:ANGIE
Middle Name:L
Last Name:HILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 465
Mailing Address - Street 2:102 MARY SHARP DRIVE
Mailing Address - City:DECHERD
Mailing Address - State:TN
Mailing Address - Zip Code:37324-0465
Mailing Address - Country:US
Mailing Address - Phone:931-967-6861
Mailing Address - Fax:931-967-7643
Practice Address - Street 1:102 MARY SHARP DR
Practice Address - Street 2:
Practice Address - City:DECHERD
Practice Address - State:TN
Practice Address - Zip Code:37324-3806
Practice Address - Country:US
Practice Address - Phone:931-967-6861
Practice Address - Fax:931-967-7643
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS 74871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice